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DSH100067 ST. ANTHONYS HOSPITAL (Terminated)
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Main Details
Name
ST. ANTHONYS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100067
Medicare Provider Number
100067
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2020
Participating Start Date
10/1/2020
Participating Approval Date
7/28/2020
Last Recertification Date
9/8/2023
Termination Date
Termination Reason
7/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Baycare Health System
Carl Tremonti, Chief Financial Officer
(813) 870-4020
Primary Contact
BayCare Health System
Kyle J Brauer, Manager, BayCare Pharmacy Supply Chain
(813) 901-6376
Addresses
Street Address
1200 7TH AVENUE NORTH
ST. PETERSBURG, FL 33705
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating start date 10/1/2011; Terminated 10/1/2015; Reinstated 10/1/2020.
07/16/2020
April 2025
April 2025
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